Relapsing polychondritis is not one disease with variable severity. A French cohort splits it into three clusters whose mortality runs 4%, 13% and 58% — and the worst cluster is almost certainly VEXAS, which this review argues should be treated as a disease mimic rather than a subtype. Chondritis is absent at presentation in 40%, there is no confirmatory test, and no randomised trial has ever been conducted.
ACPA-positive and ACPA-negative RA take the same total time from first symptom to arthritis — but split it in mirror image. Seropositive patients reach the rheumatologist later and convert faster; seronegative patients arrive sooner and linger, leaving roughly twice as long an actionable window once they are in front of you. Each entity carries its own signature before arthritis exists.
A 2026 narrative review arguing that B cells are the single through-line of Sjögren disease — connecting autoantibodies, glandular pathology, the highest lymphoma risk of any autoimmune disease, and the emerging drug pipeline. Endotyping by B-cell activity may identify who develops lymphoma and who responds to B-cell-targeted therapy, as newer BAFF/APRIL, CD40L, BTK and FcRn agents succeed where rituximab failed.
A 2026 review of renal involvement in systemic sclerosis — a spectrum well beyond scleroderma renal crisis (SRC), covering the diagnostic constellation, five converging mechanisms, risk factors (anti-RNA polymerase III, early dcSSc, steroids), and the management essentials: immediate ACE inhibition, never stopped for a rising creatinine.
A 2026 review of pathogenesis-directed SLE therapeutics anchored to the 2025 ACR SLE and 2024 ACR lupus nephritis guidelines — the FDA-approved and off-label drugs by mechanism, indication and monitoring, plus the metabolic/mitochondrial, IL-1, cardiometabolic and non-pharmacological strategies, mapped by organ manifestation.
A 2026 narrative review of the IL-5/eosinophil axis in eosinophilic granulomatosis with polyangiitis (EGPA) and the two approved IL-5 pathway inhibitors — mepolizumab and benralizumab — covering their mechanisms, MIRRA and MANDARA trial evidence, real-world data, guideline positioning, and the remaining unmet needs.
In the TELIGAN phase 3 trial, telitacicept — a dual BAFF/APRIL inhibitor already approved for SLE — reduced 24-hour proteinuria by 55% relative to placebo at 39 weeks in adults with IgA nephropathy, with eGFR remaining stable on treatment while declining on placebo.
This 2026 Nature Reviews Rheumatology paper reframes SLE autoantibody production by contrasting the germinal-centre and extrafollicular B cell pathways — their distinct kinetics, affinity profiles, T cell dependence, and therapeutic vulnerabilities — showing that the inflammatory niche, not intrinsic autoreactivity, determines pathogenic B cell fate.